physicians balk at sending
that amount of laser energy
into a patient's eye, but it's
safer to do if you're work-
ing with coaxial illumina-
tion and consider the basic
physics of laser technology.
When the laser is fired into
the vitreous, a small
acoustic wave of energy is
emitted and some of the
energy wave is sent back
toward the laser's source.
There is a nonlinear rise in
the dispersion of energy
that takes place. That
means increasing the laser's
energy from 5 to 10 milli-
joules does not double the
amount of energy delivered
into the eye. Instead, the
energy is increased by just 30 to 40%. That's an important safety con-
cept to understand.
• Number of shots. Many surgeons stop at 50 to 60 laser shots
when treating floaters, but that's not nearly enough in some cases.
Our practice conducted a study involving more than 300 patients that
found that about 180 shots were needed to pulverize Weiss rings/soli-
tary opacities and 500-plus shots were needed to eliminate amor-
phous cloud-like floaters. It's acceptable to use that many shots
because YAG laser energy is delivered in a series of 4 nanosecond
1 0 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6
Vitreolysis performed with the
latest illumination technology
gives surgeons the confidence to
use the level of energy needed
to effectively vaporize floaters.
